Attenuation of drug-induced anxiety dreams and pavor nocturnus by benzodiazepines

Anxiety dreams and night terrors have been reported as complications of single-dose bedtime administration of both tricyclic antidepressants and neuroleptics. Five cases are presented that demonstrate the effectiveness of diazepam and its close relative clorazepate in controlling this problem. The clinical usefulness and possible mechanisms of action of these agents in treating sleep disorder are discussed.     

Pavor nocturnus of proven epileptic origin

PURPOSE: To evaluate the suspected epileptic origin in children with episodes masquerading as sleep terrors. METHOD: One such child was investigated with scalp-derived long-term monitoring (LTM), inter and ictal single photon emission computed tomography (SPECT) scans, and an invasive LTM, followed by surgical subpial slicing of the focally discharging motor cortex. RESULTS: The scalp-derived LTM and the SPECT scans did not localize the suspected epileptogenic focus. The invasive LTM revealed the focal onset of the ictal discharge. After the surgery, the seizures have been 90% controlled. No deficits resulted from the surgery. CONCLUSIONS: Although most nocturnal terrors (NTs) are parasomnias, in a few children their frequent episodes that masquerade as NTs have an epileptic origin. There are several features to distinguish these from common NTs or from other frontal lobe epilepsies.     

Treatment of somnambulism in military trainees.

Of 12 otherwise health individuals facing honorable discharge from the military because of intractable sleepwalking, six chose to participate in a short-term treatment program involving hypnosis. Four of these reported total alleviation of symptoms. Therapeutic design and treatment implications are discussed and a brief review of the literature is presented.     

Electroencephalography in tetanus

ABSTRACT To assess the brain involvement caused by tetanus, we examined the EEGs of 39 patients recovered from tetanus and those of 39 sex- and age-matched controls. The patients had significantly more frequent and more severe EEG abnormalities than their controls. The most marked difference was in the occurrence of diffuse EEG abnormalities (P < 0.05). Twenty patients had normal EEGs. EEGs of 14 patients (5 of whom in this follow-up) during acute tetanus showed abnormalities in 10 patients, marked in degree in 3 of those. EEG abnormalities started to improve after the acute phase of tetanus. It is concluded that EEGs of patients with tetanus are often abnormal and that EEG is helpful in revealing brain involvement in patients after tetanus.     

Medication-induced somnambulism in a patient with schizoaffective disorder

A 39-year-old man with schizoaffective disorder experienced somnambulism only when taking a combination of lithium carbonate, chlorpromazine, triazolam, and benztropine. This was confirmed in the sleep laboratory. The sleepwalking occurred during Stage 2 sleep; the sleep record showed a marked paucity of REM sleep. The patient's brother had had one episode of somnambulism, also following exposure to a substance affecting the CNS. A role for CNS-active medications in triggering some pathologic sleep phenomena in predisposed individuals is hypothesized. Medications with central anticholinergic activity may be particularly important.